Tang Qianyun, Wang Fengling, Yang Jingjing, Peng Hua, Li Yu, Li Bin, Wang Shuhong
Xiangya Hospital, Central South University, Changsha, China.
Xiangya School of Nursing, Central South University, Changsha, China.
Front Aging Neurosci. 2020 Feb 5;11:370. doi: 10.3389/fnagi.2019.00370. eCollection 2019.
Blood lipid profiles have been ambiguously reported as biomarkers of AD in recent years. This study was conducted to evaluate the correlation between blood lipid levels and AD in later-life and to explore the effectiveness and reliability of blood lipid profiles as biomarkers of AD. Database searching was conducted using PubMed, the Cochrane Library, EMBASE, and Medline. This study was designed following the Meta-analysis of Observational Studies in Epidemiology (MOOSE) criteria. Review Manager 5.3 (RevMan 5.3) software was adopted to perform meta-analysis evaluating the standard mean difference (SMD) with its 95% confidence intervals (CI). A total of 5,286 participants were enrolled from 27 case-control studies in this meta-analysis. The pooled results demonstrated that total cholesterol (TC) level was significantly associated with AD in late-life (SMD = 0.17, 95% CI: [0.01, 0.32], = 0.03), especially in the subgroup under 70 years old (SMD: 0.45, 95% CI: [0.11, 0.79], = 0.01) and the subgroup of Western population (SMD: 0.29, 95% CI: [0.04, 0.53], = 0.02). In the subgroup under 70 years old, the high-density lipoprotein cholesterol (HDL-C) level (SMD = -0.50, 95% CI: [-0.76, -0.25], = 0.0001) and the low-density lipoprotein cholesterol (LDL-C) level (SMD = 0.59, 95% CI: [0.02, 1.16], = 0.04) in the AD group were significantly lower and higher than in the control group, respectively. In the subgroup with a sample size larger than 100 subjects, the LDL-C level was significantly higher in AD patients than in the control elderly group (SMD = 0.31, 95% CI: [0.05, 0.56], = 0.02). There was no significant association between triglyceride (TG) levels and AD in later-life (SMD = -0.00, 95% CI: [-0.12, 0.12], = 1.00). TC can be a new predictive biomarker of AD or cognitive decline in later-life. Increased TC levels are found to be associated with an elevated risk of AD. Decreased HDL-C levels and increased LDL-C levels may relate to an elevated risk of AD in subjects aged 60-70. Further comprehensive researches will be necessary in the future.
近年来，血脂谱作为阿尔茨海默病（AD）的生物标志物的报道并不明确。本研究旨在评估晚年血脂水平与AD之间的相关性，并探讨血脂谱作为AD生物标志物的有效性和可靠性。通过PubMed、Cochrane图书馆、EMBASE和Medline进行数据库检索。本研究按照流行病学观察性研究的Meta分析（MOOSE）标准进行设计。采用Review Manager 5.3（RevMan 5.3）软件进行Meta分析，评估标准平均差（SMD）及其95%置信区间（CI）。本Meta分析共纳入了来自27项病例对照研究的5286名参与者。汇总结果表明，总胆固醇（TC）水平与晚年AD显著相关（SMD = 0.17，95% CI：[0.01, 0.32]，P = 0.03），尤其是在70岁以下的亚组（SMD：0.45，95% CI：[0.11, 0.79]，P = 0.01）和西方人群亚组（SMD：0.29，95% CI：[0.04, 0.53]，P = 0.02）中。在70岁以下的亚组中，AD组的高密度脂蛋白胆固醇（HDL-C）水平（SMD = -0.50，95% CI：[-0.76, -0.25]，P = 0.0001）和低密度脂蛋白胆固醇（LDL-C）水平（SMD = 0.59，95% CI：[0.02, 1.16]，P = 0.04）分别显著低于和高于对照组。在样本量大于100例的亚组中，AD患者的LDL-C水平显著高于老年对照组（SMD = 0.31，95% CI：[0.05, 0.56]，P = 0.02）。晚年甘油三酯（TG）水平与AD之间无显著关联（SMD = -0.00，95% CI：[-0.12, 0.12]，P = 1.00）。TC可能是晚年AD或认知衰退的一种新的预测生物标志物。发现TC水平升高与AD风险升高相关。HDL-C水平降低和LDL-C水平升高可能与60 - 70岁人群的AD风险升高有关。未来有必要进行进一步的综合研究。
